Tlr2/4-Mediated Hyperinflammation Promotes Cherubism-Like Jawbone Expansion in Sh3bp2 (P416R) Knockin Mice.

Cherubism (CBM), characterized by expansile jawbones with multilocular fibrocystic lesions, is caused by gain-of-function mutations in SH3 domain-binding protein 2 (SH3BP2; mouse orthologue Sh3bp2). Loss of jawbone and dental integrity significantly decrease the quality of life for affected children. Treatment for CBM is limited to multiple surgeries to correct facial deformities. Despite significant advances made with CBM knockin (KI) mouse models (Sh3bp2 KI/KI ), the activation mechanisms of CBM lesions remain unknown because mutant mice do not spontaneously develop expansile jawbones. We hypothesize that bony inflammation of an unknown cause triggers jawbone expansion in CBM. To introduce jawbone inflammation in a spatiotemporally controlled manner, we exposed pulp of the first right mandibular molar of 6-week-old Sh3bp2 +/+ , Sh3bp2 KI/+ , and Sh3bp2 KI/KI mice. Bacterial invasion from the exposed pulp into root canals led to apical periodontitis in wild-type and mutant mice. The pathogen-associated molecular patterns (PAMPs)-induced inflammation of alveolar bone resulted in jawbone expansion in Sh3bp2 KI/+ and Sh3bp2 KI/KI mice. CBM-like lesions developed exacerbated inflammation with increased neutrophil, macrophage, and osteoclast numbers. These lesions displayed excessive neutrophil extracellular traps (NETs) compared to Sh3bp2 +/+ mice. Expression levels of IL-1ß, IL-6, and TNF-α were increased in periapical lesions of Sh3bp2 +/+ , Sh3bp2 KI/+ , and Sh3bp2 KI/KI mice and also in plasma and the left untreated mandibles (with no pulp exposure) of Sh3bp2 KI/KI mice, suggesting a systemic upregulation. Ablation of Tlr2/4 signaling or depletion of neutrophils by Ly6G antibodies ameliorated jawbone expansion induced by PAMPs in Sh3bp2 KI/KI mice. In summary, successful induction of CBM-like lesions in jaws of CBM mice is important for studying initiating mechanisms of CBM and for testing potential therapies. Our findings further emphasize a critical role of host immunity in the development of apical periodontitis and the importance of maintaining oral health in CBM patients. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Substance P and CGRP expression in dental pulps with irreversible pulpitis.

The purpose of this study was to compare substance P (SP) and calcitonin gene-related peptide (CGRP) expression in pulp tissue with clinically diagnosed symptomatic and asymptomatic irreversible pulpitis. Healthy pulps acted as controls. Five normal pulps and 40 with irreversible pulpitis (20 symptomatic and 20 asymptomatic) were obtained from 45 different patients. SP and CGRP expression was determined by competition binding assays using enzyme immunoassay. anova and Mann-Whitney tests were used to ascertain if there were statistically significant differences between the groups. The results showed that neuropeptides were found in all pulp samples. The highest and the lowest expressions for SP and CGRP were found in symptomatic irreversible pulpitis and healthy pulps groups, respectively. The differences between healthy pulps and the groups of pulps having irreversible pulpitis were significant (P < 0.001). Although Mann-Whitney's post-hoc tests showed statistically significant differences in CGRP expression between two pulpitis groups (P < 0.05), differences in SP expression between symptomatic and asymptomatic irreversible pulpitis groups were not significant. This study demonstrated that the expression of CGRP and SP is significantly higher in pulps with irreversible pulpitis compared with healthy pulps.

Endodontic treatment of a mandibular first molar with three mesial canals and broken instrument removal.

To succeed in any dental procedure, the clinician's awareness of the patient's dental anatomy and its variations is crucial. In endodontic therapy, obtaining full information about the root canals' variations can affect the outcome substantially. This case report presents the endodontic treatment of a mandibular first molar exhibiting three mesial root canals with 4 mm of a separated K-file in the coronal third of the mesiolingual canal on an 18-year-old female patient. This case demonstrates the importance of locating additional canals in any roots undergoing endodontic treatment and how the clinician's awareness of aberrant internal anatomy may change the treatment results.

The knowledge and attitude of general dentists toward denture adhesives in Tehran.

BACKGROUND: The purpose of this study was to generate discussion and communication among a group of general dentists in Tehran on their viewpoints regarding denture adhesives. Have they accepted denture adhesive as a material to enhance denture retention, stability and function? MATERIALS AND METHODS: In the summer of 2007, a questionnaire was mailed to 300 general dentists who were assigned with a random systematic sampling method from general dentists in Tehran. The questions were arranged in two parts of evaluating knowledge and attitude. In evaluation of knowledge, dentists were classified into groups of good, moderate, weak and lack of knowledge. In evaluation of attitude, dentists were classified into positive, moderate and negative groups. (Evaluating attitude was carried out in good and moderate groups of knowledge.) RESULTS: The study showed that 14%, 32% and 37% of the general dentists had respectively good, moderate and weak knowledge toward denture adhesive while 16.3% had no knowledge about this material. In evaluation of attitude through dentists with positive and moderate knowledge toward denture adhesive, 9.3%, 71.3% and 19.4% had respectively positive, moderate and negative attitude toward denture adhesive. The chi2 test showed a significant statistical relation between situation of knowledge and experiences of dentists. DISCUSSION: This study demonstrated that the rate of knowledge of these 300 general dentists in Tehran towards denture adhesives has not been in a good situation. It is believed that denture adhesive be able to enhance the fitness of a denture and provide psychological relief to the patient. Dentists agreed that education, not only for practitioners but also for patients, would raise the advantageous features and reduce the misuse of denture adhesive. Education of the topic "Denture adhesive" should be more concerned in dental universities.

Effect of 17% EDTA and MTAD on intracanal smear layer removal: a scanning electron microscopic study.

The purpose of this study was to determine the effectiveness of MTAD as the final irrigant to remove the smear layer, compared with that of 17% EDTA, both following root canal irrigation with 5.25% sodium hypochlorite (NaOCl). Fifty-five extracted maxillary and mandibular single-rooted human teeth were prepared by a crown-down technique using rotary 0.04 and 0.06 taper nickel-titanium files. 5.25% sodium hypochlorite was used as the intracanal irrigant. The canals were then treated with 5 mL of one of the following solutions as final rinse: 5.25% sodium hypochlorite, 17% EDTA or MTAD. The presence or absence of smear layer in the coronal, middle and apical portion of each canal was examined with a scanning electron microscope. The results showed that MTAD is an effective final rinse solution for removing the smear layer in canals irrigated with sodium hypochlorite. When 17% EDTA was used as a final rinse, the smear layer was removed from the middle and coronal thirds of canal preparations, but it was less effective in the apical third of the canals.

The side effects of orthodontic mechanics in orthodontic treatments.

The side effects of orthodontic mechanics at each tissue level (alveolar bone, periodontal ligament, gingiva, pulp, cementum, and enamel) are addressed, along with the issue of pain following orthodontic appointments, and psychobehavioral alterations observed in orthodontic patients. It is necessary to know how orthodontic treatment affects enamel health, including methods to manage these side effects, which are still a dilemma for orthodontic clinicians. It is interesting to note that the dental pulp, which lies deep in the tooth core, also reacts to orthodontic force. The way the periodontal ligament responds to light and heavy forces, in young and adult patients, with or without periodontal disease, should be considered. Root resorption is a well-recognized phenomenon following orthodontic treatment. Advances made in this area of research to identify the parameters and genes associated with this process are developing.

A comparison of three Ni-Ti rotary instruments in apical transportation.

The purpose of this study was to compare apical transportation and changes in canal curvature of three nickel-titanium (Ni-Ti) rotary instruments: Hero 642, RaCe, and ProTaper. Mesiobuccal canals of 60 maxillary first molars (with angles of curvature between 25 degrees and 35 degrees) were prepared with a torque-control, low-speed engine. Canals were prepared using the crown-down technique to the size of #30. Using a radiographic platform, reproducible preinstrumentation and postinstrumentation radiographs were taken. A computer analysis allowed magnification and superimposition of the images. The central axes of initial and final instruments were radiographically superimposed to measure transportation at 1 mm from WL. Data were analyzed using repeated-measures ANOVA. A statistically significant difference in apical transportation was found in ProTaper group. The results suggest that ProTaper file system be implemented in combination with other less tapered more flexible systems, like RaCe, in preparing curved canals.